Step Into Swim Grant Application

Name *

First Name Last Name

Title *

Email *

example@example.com

Organization's Name *

Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Phone Number *

- Area Code Phone Number

Organization type. *

Please describe your current "Learn to Swim" or Swim Program. *

50 - 75 words

What is the estimated number of students currently enrolled in your swim program? *

What are your current goals for growth of your swim program? *

50-75 words

Do you utilize an outside service company to assist you in pool maintenance? If so, please include their company name, city and state?

Do you utilize any of these manufacturers equipment?

Do you have a CPO Certified Pool Operator on Staff? *

Yes No

If you answered Yes, to having a CPO Operator on Staff, please note the individual's name here.

What is the amount of funding you are requesting?

$0 - $250 $250 - $500 $500 or more

Would you have matching funds to assist you?

Yes No

Should you receive funding from Step Into Swim, your organization agrees to provide a summary, with photos and/or videos of the program in action by December 31, 2018. These items may be used for promotional, social media, annual reports and more. By agreeing, you are granting permission to Step Into Swim to use any and all submitted items.

Yes, I agree to supply documentation for the Step Into Swim program.

Upon completing this form, Step Into Swim will review your program description and contact you with additional questions or potential support.

Step Into Swim Funding Request